How to Manage Decreased Libido While on Antidepressants
For some people with depression, antidepressants can be lifesaving. The most common forms used to treat anxiety and depression are selective serotonin reuptake inhibitors. SSRIs are known to impact all four stages of the sexual arousal cycle, including desire, arousal, orgasm and resolution, impacting up to 60 percent of patients. It might seem like your sex drive will be collateral damage in the pursuit of better mental health, but it doesn’t have to be. There are several ways you can up your libido after SSRIs kick in.
If you want to take antidepressants without impacting your sex drive, there are drug alternatives that may be right for you. Wellbutrin, a brand name for bupropion, for instance, is a norepinephrine and dopamine reuptake inhibitor that has many of the same side effects as SSRIs, but may not affect the sexual arousal cycle and can even increase your libido.
The drug can be taken as a standalone antidepressant or in addition to an SSRI. If you are prone to seizures or have an eating disorder, doctors say you should not take Wellbutrin.
“Bupropion is known to reduce seizure thresholds, with a seizure rate of about 1 in 1000 subjects treated,” writes Dr. Eric Wooltorton, an Ottawa-based general practitioner. He continues, “[Bupropion] should not be administered to patients with conditions altering the seizure threshold, including anorexia nervosa or bulimia.”
If switching to Wellbutrin is not an option and a low libido is getting you down, you may want to consider lowering your dosage. Dr. Robert L. Phillips, a family physician and the vice president of research and policy at the American Board of Family Medicine, writes that in “one study, 73 percent of patients whose SSRI dosage was halved reported improved sexual function while antidepressant effectiveness continued.”
Phillips also notes that people with “major depressive disorder or bipolar disorder have an even higher prevalence of sexual dysfunction” than the general population. The explanation behind this is that sexual dysfunction is a symptom of depression and will impact your libido regardless of whether or not you are taking medication. As a result, treating your depression first can positively impact your sex drive.
Norman L. Keltner, a professor at the School of Nursing at the University of Alabama, writes, “[P]atients can plan activities when drug levels are their lowest […] [such as] right before the next dose is scheduled to be taken.” Patients taking drugs with short half-lives, such as sertraline and clomipramine may find this method the most effective.
While some physicians may advocate a drug holiday — a brief period in which antidepressant users abstain from taking their medication for improved sexual function — Dr. Agnes Higgins, a professor at the School of Nursing and Midwifery at Trinity College in Dublin, warns against it.
Higgins warns that those considering a drug holiday should keep in mind they may experience “withdrawal symptoms associated with their particular medication [that] […] may render the individual unable to engage in sexual activity.”
An important thing to note is that while sex drives may be lower than usual, it’s still possible to get aroused and orgasm. Foreplay can be an integral part of sexual satisfaction and one that should never be missed.
The bottom line: Take some pressure off yourself by keeping in mind that depression and sexual dysfunction are usually correlated and treatable.
By Deidre Olsen